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Peace Corps' Niche in Malaria Control HEALTH ISSUES

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Peace Corps' Niche in Malaria Control HEALTH ISSUES Peace Corps Our Health Edition— Endorsing the Notion Fall 2007 that "Every Day is Times AIDS Day" Volunteers Make Hearth Model Work In this edition we address health issues—those faced by the communities in which Volunteers live, and those faced by Volunteers themselves as they adjust to local living conditions in their communities overseas. We begin here with a health issue that affects everyone in local commu- nities—malnutrition in young children. More than one-quarter of all children under five in the developing world are underweight due to an inadequate or improper diet. Malnutrition can be severely harmful to the physical and mental development of a child. In addition to stunting growth, malnutrition saps a child’s ability to resist infection and increases the risk of death from common childhood illnesses such as diarrhea and respiratory infections. However, when children receive a balanced, adequate diet, they are much better able to ward off illnesses, and have a better chance of surviving and thriving. Peace Corps health advisors want to raise awareness of a model for combating malnutrition in young children called the Hearth model that PCVs throughout the world are currently using with great success. The hearTh Program ties by identifying “positive deviants” or helena hart, an education Volunteer in Benin (2000-03), those within the community who are admires a mother’s new babies. The “Hearth Nutrition Model/Positive already doing things right. That person’s Deviance” (the Hearth) is one of the most methods are examined, and they are then The mothers exchange ideas as well as Hearth interventions can also be a promising nutrition interventions for the asked to replicate what they do in the cooking recipes during the sessions, and starting point for other activities and rehabilitation of malnourished children audience of others in the community. The the model mother talks about the effects serve as a catalyst for new work ideas. A It was introduced in Haiti in the 1980s approach is based on the premise that of certain practices on the health of their fixed strategy to address child nutrition, and has been replicated by nongovern- some solutions to community problems children. A health worker, sometimes for example, can be developed with local mental organizations in Bangladesh, already exist within the community and a Volunteer, is often present to answer health personnel based on the informa- Mozambique, Tanzania, and Vietnam. simply need to be discovered. questions and provide clarification on tion gathered during the project. In 1997, Africare launched the Hearth Using the typical Hearth model, a common health issues and concerns. With a little creative thinking (and in Guinea where rates of malnutrition “model mother” with healthy children just leave it up to PCVs to get creative), were as high as 30 percent. Findings from would be identified and would guide hearth goals the principles of the Hearth model might the Hearth in Guinea revealed that 85 other mothers, accompanied by their Immersed in their communities and also be applied to issues in other Peace percent of children participating in the young children, through a series of equipped with cross-culture skills and Corps working sectors, such as education, program gained weight (had adequate cooking and hygiene sessions once a day language abilities, Volunteers are well- natural resource management, youth, or growth or catch-up growth) after just for 12–14 days. The young children are suited to carry out Hearth. The approach business development. two weeks. Moreover, qualitative studies weighed and measured at the beginning leverages local resources and requires suggest that mothers who participate in of each session to determine weight little or no outside funding; instead, it the Hearth continue to practice the posi- gain from improved diet and hygiene. promotes ownership and active engage- tive childcare and feeding behaviors even This information is recorded on growth ment by the community. Recipes are ThreeHearthGoals after the Hearth. chart so mothers can understand their developed that use low-cost ingredients children’s progress over the course of the that are easily obtained, grown, or gath- 1. To quickly rehabilitate What is a “Positive Deviant?” sessions. The model mother then teaches ered in the local environment. Those who malnourished children Positive deviance is defined as the de- the other mothers present a new recipe, have already implemented the Hearth identified by the community. parture from a traditional way of doing and sessions typically end with all of the model in their communities describe things to a way that is more beneficial, children present eating a big serving of a it as quick, affordable, participatory, 2. To enable families to sustain desirable and successful. The Hearth porridge or some other tasty and nutri- indigenous, culturally acceptable and rehabilitation of children at model solves problems in communi- tious new food. sustainable. home on their own. Unlike many interventions designed to improve child nutrition, the Hearth 3. To prevent future malnutrition “Behaviorchangeisaprocess.Evenifawomanrejects approach presents Volunteers and their among all children in the myinformationtoday,whenitcomestimeforthat communities with immediate and tan- community by changing gible results. Children usually show community norms in child care, woman’sdaughtertoheartheinformationitwillnotbe weight gain and an increase in energy feeding practices, and health- suchaforeignconcept.” during the first two weeks, which moti- seeking practices. Cathleen Prata, PCV Mali vates mothers to attend sessions regularly and to embrace positive new practices and behaviors. Continued on page 7 HealtH Issues Peace Corps’ Niche in Malaria Control “BystandingwiththepeopleofAfricainthefightagainst malaria,wecanhelpliftaburdenofunnecessarysuffering, providehopeandhealth,andforgelastingfriendships.” President George W. Bush at a Malaria Awareness Day Event, April 24, 2007 malaria Preys Upon Peace Corps Volunteers, filling a Vulnerable Populations needed niche in grassroots community- based education, have carried out salient Malaria, the disease transmitted by para- health education activities focused on sites living in the saliva of mosquitoes, is malaria. And by helping to build and a real killer. In sub-Saharan Africa alone, strengthen the capacity of health facilities malaria kills 1 million infants and children and organizations, Peace Corps Volunteers under age five every year—approximately have also contributed to efforts to address one child every 30 seconds. malaria. Very young children, pregnant wom- laura Bassett, Volunteer in Uganda(left), discusses the dangers of malaria and en, and people living with HIV/AIDS are promotes prevention techniques such as the regular use of mosquito nets. at highest risk for malaria morbidity and What Volunteers are Doing mortality due to weak or limited immu- nity. Adult and child deaths and sickness mali mothers with children younger than five Togo due to malaria occur for many compli- Twelve Volunteers work with their com- years of age. As a result, 800 community Peace Corps Volunteers helped health cated reasons, many rooted in poverty, munities on building soak-pit and wash- members are using bed nets for malaria personnel organize and carry out an in- such as affordability of health services ing areas to eliminate standing water, prevention. A project called “Nets for tegrated campaign against malaria and and products, accessibility to healthcare, thereby reducing potential breeding Test” begins this year to create a justifi- vaccination against measles. Numerous and quality of healthcare. ground for mosquitoes. As a result, 201 able incentive for encouraging HIV/AIDS mothers got mosquito nets and children While working in the area of malaria soak pits, seven cement washing areas, testing because it will also protect a vul- were immunized against measles. Vol- prevention and control is an important four animal washing troughs, and 20 nerable population from being infected unteers also continue health talks on part of some Peace Corps health projects, hand-washing stations have been built with malaria. malaria prevention with women dur- it may require more creativity than other throughout Mali. The project’s vision contains three ing infant growth monitoring, prenatal health activities for a number of reasons. Through group and individual conver- components: 1) four extensive group consultations and vaccination sessions For example, there may be fewer re- sations, several Volunteers have provided trainings to create educated people in at rural dispensaries. Some have been sources/tools to help facilitate the work; information about the dangers of malaria the field of malaria and HIV/AIDS; 2) participating in the ongoing training of there may be challenges making the cause and methods of prevention. As a result, free mosquito net distribution to those community health workers (CHWs) in the (mosquito) and effect (malaria) associa- 850 community members have been who get tested for HIV/AIDS; and community-based care of malaria cases. tion; and most interventions have costs educated about how malaria is spread and 3) five to 10 campaigns to promote the Trained CHWs are provided with tablet associated with them. Nevertheless, since trained to eliminate standing water. projects and create awareness of health packs of Coartem® and Paracetamol, the malaria is such a devastating and endemic issues in the
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